أورام الكبد / السرطان في الأطفال
Liver tumours account for 1% of all cancers in children. The liver cancers in children are entirely different from adults. The liver tumours in children are called hepatoblastoma, while adults has hepatocellular carcinoma. The good thing about children liver tumour is that, it is 95% curable with chemotherapy and resection even in late stages, while adult liver cancers the outcome is poor even in early stages.
Usually parents notice abdominal distension and take to doctors, doctors wouldn’t be able to find anything in initial stages, unless liver ultrasound is performed. Some times they seek medical attention for constipation. Usually they don’t get jaundice or features of chronic liver disease like vomiting blood. After two or three months when the abdomen is grossly distended, the doctor will be able to palpate the tumour and diagnose it. This tumour secretes a substance called “alpha feto protein” which can be measured in blood and confirm the disease. This ”alpha feto protein” helps in monitoring the disease activity and goes down to normal values when the disease is completely cured.
Chemotherapy consists of six cycles in total. Each cycle is twenty one days and chemotherapy drugs are given as inpatients for three days followed by a gap of eighteen days during which the child would be sent home. Liver resection is done after completion of four cycles. If the tumour is large or near vital stuctures such as artery or bile ducts, then liver resection might not be possible and liver transplantation has to be done. Two cycles of chemo would be given after resection or liver transplantation.